‘Top Docs’ show on risk-adjusted reimbursement now online
A recording of a recent Medical Association of Georgia (MAG) ‘Top Docs Radio’ show that addressed “patient risk scoring” and what steps physicians and practice staff can take to succeed under the new value-based, pay-for-performance system is now available online.
The show featured Ronnie R. Smith, M.D., an internist with Vidalia Medical Associates, P.C.
“Physicians in the United States find themselves in a seismic paradigm shift from volume-based reimbursement to value-based reimbursement.” says Dr. Smith. “This is being driven by escalating health care costs and an increasingly-sicker population.”
He explains that, “Pay-for-performance is based on patient risk scoring, and quality measures are being used at every level of our health care system. These changes are meant to stimulate quality improvement and cost-efficiency within the health care system.”
Dr. Smith believes that, “Physician reimbursement that is tied to patient risk scoring is here to stay, so it is imperative for physicians to understand how patient risk scoring works because it will affect their income in significant ways.”
And Dr. Smith notes that, “If a physician fails to recognize risk-adjusting diagnoses and under code them, they will likely fail under today’s value-based reimbursement system – and the clinical management of the utilization-based spending that will be required to qualify for any shared savings incentives will no doubt be challenging.”
Finally, Dr. Smith stresses that, “Physicians who accurately and thoroughly document how sick their patients stand a far better chance of achieving their budget objectives. This gives them the best opportunity to receive the shared savings incentives and to minimize their risk for shared losses.”
MAG sponsors the ‘Top Docs’ program at 12 p.m. on the second and fourth Tuesday of every month. Between downloads and live listeners, MAG's ‘Top Docs’ show has reached more than 10,000 listeners – which includes people in all 50 states and 84 countries.
MAG’s ‘Top Docs Radio’ show is supported with a grant from Health Care Research, a subsidiary of Alliant Health Solutions.